E035 Beliefs and opinions on patient-initiated follow-up (PIFU) in rheumatology: insights from the South Coast Axial Spondyloarthritis Network (SCAN)

Abstract Background/Aims Patient-initiated follow-up (PIFU) is promoted across the NHS as a model to support patient empowerment and service sustainability. In rheumatology, where chronic disease management requires balancing safety and flexibility, PIFU offers potential advantages but raises concerns regarding equity and disease monitoring. The British Society for Rheumatology (BSR) and NHS England have issued guidance highlighting the need for structured eligibility criteria, shared decision-making, digital monitoring, and safety-net appointments. The aims of this study were to explore experiences and perceptions of PIFU across the South Coast Axial Spondyloarthritis Network (SCAN), and to compare these findings with BSR/NHS guidance to identify priorities for safe and effective implementation. Methods An anonymous online survey was distributed across nine hospitals in the SCAN network. The survey included demographic, closed, and free-text questions covering familiarity, experience, perceived strengths, weaknesses, barriers, and enabling factors for PIFU. Fifty-six responses were received. Findings were compared with national guidance as described in the BSR PIFU Clinicians’ Handbook. Results Respondents were rheumatologists (47%; n = 26/56), nurse specialists (25%; n = 14), physiotherapists (11%; n = 6), and others (17%; n = 10). Most had greater than 10 years’ experience (53%; n = 30) and worked in hospital clinics (92%; n = 51). Eighty-one percent (n = 45) had prior experience with PIFU, with 50% (n = 28) very familiar. Perceived strengths included improved patient autonomy (60%; n = 34), reduced waiting times (63%; n = 35), better alignment with patient needs (63%; n = 35), and reduced resource burden (54%; n = 30). Reported weaknesses reflected BSR concerns: risk of delayed care for flares (47%; n = 26), inadequate monitoring (56%; n = 31), inequity of access (44%; n = 25), and patient anxiety (28%; n = 16). Critical success factors mirrored national guidance: clear eligibility (75%; n = 42), effective patient education (69%; n = 39), staff training (58%; n = 32), robust communication (58%; n = 32), and digital integration (39%; n = 22). Confidence in identifying suitable patients was high (88% at least somewhat confident). Most agreed PIFU could reduce workload (83%; n = 46), primarily via reduced unnecessary reviews (89%; n = 50). However, 53% (n = 30) highlighted risks to providers, including increased urgent workload and challenges in long-term monitoring. Desired support included patient education materials (54%; n = 30), staff training (46%; n = 26), digital tools (49%; n = 27), and standardised guidelines (63%; n = 35). Conclusion Findings from SCAN show broad alignment with BSR/NHS guidance. Professionals value autonomy, flexibility, and efficiency gains, but have concerns around safety netting, digital inequality, and sustained monitoring. Structured frameworks and integrated digital pathways are viewed as essential to mitigate risks. Rheumatology clinicians across SCAN broadly support PIFU, consistent with national guidance, but highlight critical enablers for safe implementation. Co-produced eligibility criteria, patient education, digital integration, and safety-net reviews remain key to delivering equitable, sustainable PIFU models. Disclosure A. Chan: Honoraria; Abbvie, Novartis, UCB. Member of speakers’ bureau; Novartis, UCB, Medac. K. Rigler: None. C. Jeffries: None. A. Coy: None. R. Moitra: None. D. Wallis: None. E.L. Williams: Honoraria; Sponsorship for conference attendance from Novartis and UCB. Member of speakers’ bureau; Speaker fees from AbbVie and Lilly. G.S. Dulay: Honoraria; Abbvie, Roche/Chugai, Amgen, Lilly, Sandoz, Thornton Ross/Internis, UCB, Galapagos, Medac Pharma, Pfizer Alfasigma/Galapagos, Lilly, Internis. Member of speakers’ bureau; Abbvie, Roche/Chugai, Amgen, Lilly, Sandoz, Thornton Ross/Internis, UCB, Galapagos, Medac Pharma, Pfizer Alfasigma/Galapagos, Lilly, Internis.